Following up on the initial success of its sleep apnea screening program, New York’s Metro Transit Authority (MTA) announced that it will be expanding the program to all commuter rail drivers. The safety benefits of screening are such that it is likely the MTA is just ahead of national rules requiring such screening.

Recommendations Following a Deadly Accident

man falling asleep on the subwayThe MTA hasn’t been screening its drivers for sleep apnea for very long. The program started in 2015, based on the recommendations of the National Transportation Safety Board (NTSB). The NTSB cited sleep apnea as a major cause in the deadly derailment accident on December 1, 2013 in the Bronx. The driver fell asleep at the wheel of the train, pressing the accelerator when he should have been braking. The train was traveling 82 mph in a 30 mph zone when it derailed. The accident killed four people and injured more than 60. Property damage was over $9 million, and liability lawsuits could cost hundreds of millions.

The NTSB said the driver had sleep apnea and that his shift work exacerbated the daytime sleepiness associated with the condition. But, more importantly, the driver exhibited many of the warning signs when he presented for his annual work physical, and when he talked to his personal physician. He complained of sleepiness and chronic fatigue, and noted that his wife told him about his snoring. These were signs of sleep apnea that should have been recognized, but, instead, the driver was diagnosed with low testosterone and hypothyroidism.

The NTSB report notes that the driver’s sleep apnea symptoms completely resolved within 30 days of treatment.

Screen, Test, Treat

The MTA screening program is simple, but effective. Initially used on the 436 drivers in the Metro North division (the one where the derailment occurred), it has proven to be inexpensive, yet effective.

When drivers have their regular physical exams, medical examiners consider several risk factors for sleep apnea, such as neck circumference and body mass. If a driver is at elevated risk for sleep apnea, they are assigned a take-home sleep apnea test. If a diagnosis of sleep apnea is made by a sleep physician, sleep apnea treatment is required. This may be CPAP or an oral appliance.

Allowing for take-home tests and oral appliances helps manage costs and makes the program more effective than other screening programs.

Should Your Employees Be Screened?

With the risks for workplace accidents, including commercial driver accidents, related to sleep apnea, workplace screenings for sleep apnea seem like a better idea every day. If you are an employer considering workplace screenings, or a driver who thinks he might have sleep apnea in the Detroit area, please call (248) 480-0085 for an appointment with a sleep dentist at the Michigan Center for TMJ & Sleep Wellness in Rochester Hills.